Gastroschisis and Omphalocele

Also known as: abdominal wall defects, ventral body wall defects

What are gastroschisis and omphalocele?

Gastroschisis and omphalocele are both part of a relatively uncommon group of birth defects (abdominal wall defects) that involve failure of the abdominal wall to form properly. The baby is born with the intestines and other organs such as the stomach and the liver outside the baby passing through an opening or hole in the abdominal wall.

In most cases of gastroschisis, the hole is just to the right of the navel and the uncovered intestines and other organs protrude it and sit uncovered on the abdomenal wall. Frequently the bowel is thickened and scarred by contact with the amniotic fluid before birth. The cause of this defect is unknown, but babies usually do not have any other birth defects. While it may take a long time for the babies to feed normally, these children usually have no long term problems.

With omphaloceles, the abdomen is too small to hold all the abdominal organs and they protrude through the base of the umbilical cord, covered by a thin membrane which actually protects the intestines from the amniotic fluid. Omphaloceles are associated with a number of other congenital malformations, particularly cardiac defects, and quite frequently have chromosomal abnormalities.

What are the signs and symptoms of gastroschisis and omphalocele?

Many times, these defects are found during the mother’s ultrasounds done to monitor the pregnancy. These families can benefit from pre-natal counselling to make sure the babies are deliverd safely, and plans are in place for care after birth. In addition to the obvious abdominal wall defect, babies with gastroschisis and omphalocele frequently have low birth weight, trouble feeding and breathing and underdeveloped organs. In the omphalocele babies, it is important to look for cardiac problems.

What are gastroschisis and omphalocele care options?

Gastroschisis and omphalocele will need to be repaired surgically soon after birth. If the problem is diagnosed before birth, arrangements can be made for safe transfer to a children’s hospital with specialists experienced in these techniques. A baby will need to have fluids and be fed through a needle or catheter in a vein, and other supportive measures will be necessary, until the surgery can take place.

If the defect is small, a single surgery may completely close the abdomen. If the defect is large and the abdominal cavity is too small to accommodate all the organs at once, a silo may be placed and reduction of the organs (putting them back inside) may take several days before closure can be accomplished. In the case of omphocele, sometimes “painting” the membrane with medications are chosen, with delay of the abdominal wall closure until the baby is months or years of age.